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Experienced midwives and doctors from all over the country gathered just outside a conference room in a rustic lodge in Windhoek, Namibia in the southwest corner of Africa. It’s October, 2010. I was nervous, the most junior member of a team of 4 midwives, led by Diana Beck, CNM. She had been doing this for more than 25 years – and after many years of clinical practice in this country, I was on my first international training trip. We were about to teach a clinical update of labor and delivery skills developed by midwives from the ACNM, Life Saving Skills.
Diana was relaxed and easily took charge of this large group of 24, and we junior trainers fell into her very well organized framework. But this group of very experienced midwives and doctors was a bit skeptical of us. After all, they had been practicing for years and had delivered thousands of babies. Gradually,
they began to believe that we knew what we were talking about. A big problem was that our essential supplies – cloth pelvises, baby models, etc. – were held up in customs. After much negotiation and the intervention of the Minister of Health, we finally got them. A crucial turning point came when we trainers got down on the floor to demonstrate
different possible positions for birth. They were delighted that we were so willing to get “down to earth”. They were used to a very formal educational style of experts lecturing them and our more informal, participatory style surprised them. But they took to it with enthusiasm. Many of their standard care practices were similar to ones used here in the 1960s – no dads or family members were allowed into the labor and delivery unit, all births
were done in lithotomy position, no childbirth education. So in addition to emergency OB skills, we taught them labor support techniques. They took to this with gusto. My favorite image is the birth role plays we did. We emphasized slow controlled deliveries to minimize tearing (and
LMs Work to Change Supervision to Collaboration
An Interested Parties Workshop addressing Licensed Midwifery regulations (not nurse-midwifery regulations) took place at the Medical Board of California in Sacramento on Thursday, March 29, 2012. An estimated 200 individuals, including Licensed Midwives, CNMs, student midwives, physicians and consumers from across California gathered in front of the Medical Board staff to participate in an open discussion of regulations related to Licensed Midwifery practice – specifically, the hotly debated regulatory change that would define physician supervision of licensed midwives as
a “collaborative relationship.” Input from interested parties was elicited to aid in consensus building regarding the requirement of physician supervision as stated in the Licensed Midwife Practice Act. California is currently the only State requiring physician supervision for LMs, and one of 5 states with such requirements for CNMs.
Many stakeholders were represented including California Association of Midwives (CAM), The Midwifery Advisory Council (MAC), American Congress of Obstetricians and Gynecologists (ACOG),
continued on page 7
California Nurse-Midwives AssociationState Affiliate of the American College of Nurse-Midwives
Spring 2012
Vol: 1 Ed: 2
Contents:
President’s Message, pg 2
Health Policy, Update pg 3
Lobby Day Photos, pg 4
Student Spotlight, pg 5
ACNM Annual Meeting, pg 6-7
GAC Update, pg 8
Interview Tips, pg 9
Milk Banking, pg 10
Comments or suggesions for the CNMA newsletter? Contact Maria Kammerer, CNM at [email protected].
By Kavita Noble, CNM
Teaching Life Saving Skills in NamibiaBy Susan Snydal, CNM; technical consultant, ACNM; former Chief Nurse-Midwife, Kaiser Hayward Medical Center
continued on page 10
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President’s Message
Leadership Team Spotlight: President-Elect Wende Owen
Wende at Lobby Day ––>
Greetings California nurse-midwives, student midwives, and midwife supporters!
Since we have become the California State affiliate of ACNM our membership has grown and because of you, we can do more for midwives across the state! Your membership makes a difference. As our membership has grown, our leadership has grown, too. Thank you to all the new CNMA committee members and committee chairs. We now have a membership committee, chaired by Deborah Wooley; a fundraising committee, chaired by Carrie Jacobson; an archives committee, chaired by Maria Kammerer; and our health policy committee has grown with the addition of Kavita Noble.
Our CNMA annual meeting planning committee has formed and is chaired by Claire Westdahl. This committee is developing this year’s meeting as this newsletter is being published. Mark your calendar for November 3 in Northern California. This year the CNMA annual meeting is shaping up to be better than ever – dynamic and interactive, with CEU offerings – but we need your help. To volunteer email Claire at [email protected].
Another thank you to all those that participated in our 2012 Health Policy Lobby Day last month. Your presence
in the capitol is what really shows the strength in our profession. Our legislators are starting to understand what midwives do in California and that is the first step to making a change. Our health policy team and our lobbyist are continuously working on legislation that affects our profession.
Our next big event is the ACNM annual meeting in Long Beach, June 2-7. Be sure to visit the welcome booth where we will be doing fundraising for CNMA. Notice the various educational sessions offered by CNMA members! You are also invited to the CA affiliate meeting Wednesday morning at the Hyatt. Whether you are attending the conference or not, you are welcome to join us for the CNMA Dinner Yacht Cruise on Wednesday night, June 6 at 6pm. The yacht is docked right on the harbor in front of the convention center. It will be a fun filled evening with friends and the best way to enjoy Long Beach! Contact me to reserve your tickets or buy them at the welcome booth. I’m looking forward to seeing many of you soon!
Warm regards,
Monica Viera
By Monica Viera, CNM, CNMA President
As president elect I have the great privilege and responsibility of representing California‘s CNM’s. I have been lucky to have served with CNMA for many years as the membership chair. Many of you probably remember getting your renewal in the mail from me! I benefitted greatly from serving with multiple presidents in the organization over the years and learned a great deal from each one of them. Now that my turn to serve you is rapidly approaching, I have been evaluating my personal vision for CNMA and what I would like to focus on during my term.
One of my goals for CNMA is to advocate for midwives by dispelling antiquated misconceptions about our profession in the community. It has long been my desire to reach out to the community through an educational campaign showing everyone who we are and the benefits of the midwifery model.
I also want to become CNMA to become more active in meeting our memberships needs through education. Offering to our membership professional development and educational opportunities will help us all stay at the top of the pyramid of care practitioners.
Legislative awareness has always been one of the primary functions of CNMA. I will continue to represent our membership on the state level. Working closely with our lobbyist, Political Solutions, I hope that soon we will be able to tackle the supervisory language that we practice under.
As you can see I have high aspirations for us! I hope that you will help me develop my vision into reality and help CNMA continue to grow.
Wende Owen, CNM, CNMA President-Elect
1.CNMA
Annual Meeting
2. Health Policy Day
3. ACNM Annual
Meeting
3
Health Policy Update
The first quarter of 2012 has seen a flurry of activity for the Health Policy Committee. Here is an overview of the work that we have been involved in on behalf of the members of CNMA and midwifery in California:
The California Department of Health Care Services 1. proposed regulatory change that would eliminate Medi-Cal ratio requirements for Nurse Practitioners and Certified Nurse-Midwives. Specifically, the amendments clarified that DHCS cannot require different ratios than what currently already exists for in statute. CNMA submitted a letter of support for the amendments mid-February and to-date the proposals have not yet been completed. You can find more information here: DHCS-06-017 Nonphysician Medical Practitioners www.dhcs.ca.gov/formsandpubs/laws/Pages/DHCS-06-017-NonphysicianMedicalPractitioners.aspx
At a Budget hearing in Sacramento on January 31, 2. CNMA voiced support for SB98, legislation that would immediately reinstate the Board of Registered Nursing after a sunset period that started at the beginning of 2012. Governor Brown signed the legislation into law and the BRN was reinstated mid-February. However, we continue to wait for the Governor to appoint the new board members. CNMA has written two support letters for CNM members to the board: Linda Walsh and Dianne Moore. We wish them both the best of luck – it would be an honor to have CNM representation on the BRN!
CNMA held our tenth annual Lobby/Health Policy 3. Day on March 12, 2012. The event was an incredible amount of fun! There were over 65 CNM/SNM attendees, 36 visits with lawmakers, and one fantastic bill lobbied: SB 1524 (see #6)! Our morning session prepared us for lobbying and was star-studded with Assemblywoman Susan Bonilla, Lynne Andres of Senator Hernandez’s office, Kathy Kneer of Planned Parenthood, and Tracy Weitz of UCSF ANSIRH. A big ‘thank you’ to Political Solutions, our lobby day group leaders, and the UCSF midwifery students who put together so many of our materials! Stay tuned for our next lobby day Spring 2013 – it will be even bigger and better.
On March 29, CNMA attended the “Interested Parties 4. Workshop” held by the Medical Board Staff regarding proposed amendments to Licensed Midwives’ (LM) regulations. Specifically, the LM’s Midwifery Advisory Council is attempting to address the challenges that “supervision language” places on identifying and collaborating with physician back-up. Because neither statute nor regulation defines the supervisory relationship, these regulations intend to define supervision as a collaborative relationship in hopes of encouraging more physicians to formally support midwives and women that choose midwifery care. CNMA stated support and acknowledgement of the real problems that the current regulations cause. Please see Kavita Noble’s article (page 1) for more detail and next steps.
By Kim Quang Dau, CNM and Melanie Austin, CNMCo-Chairs, Health Policy Committee
CNMA Leadership Team
President: Monica Viera, [email protected]: Wende Owen, CNM [email protected] Treasurer: Vivian Cefalo, CNM [email protected]: Jenna Shaw-Battista, CNM, [email protected]
Regional Directors:Northern CA:
Kim Dau, CNM, [email protected] Linda Walsh, CNM, [email protected]
Central CA: Rita Barron, CNM, [email protected] Stoddard, CNM, [email protected]
Southern CA: Ginny Gladwin, CNM, [email protected] Whitley, CNM, [email protected]
Health Policy Co-Chairs: Melanie Austin, CNM, [email protected] Kim Dau, CNM, [email protected]
Fundraising Chair: Carrie Jacobson, [email protected] Annual Meeting Chair: Claire Westdahl, [email protected]: Deborah Wooley, [email protected]/Archives: Maria Kammerer, [email protected]
Chapters Chairs:San Diego: Karen Ruby Brown, CNM, [email protected] County: Marci Salmon, CNM, [email protected] Angeles/Ventura: Julie Rousseau, CNM, [email protected] Empire/Desert: Sue Scott, CNM, [email protected]: Barbara Boehler, CNM, [email protected] Jose: Bethany Monte, CNM, [email protected]
continued on page 5
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Health Policy Lobby Day 2012
The California Health Workforce Development Council 5. (HWDC) (www.cwib.ca.gov/sc_hwdc.htm) has an ad hoc Action Plan Committee that put together action plans for multiple disciplines, including Nursing. The HWDC mission is “to help expand California’s health workforce in order to provide access to quality healthcare for all Californians.” The Action Plans are intended to solidify the infrastructure for California’s health workforce. At the end of March, CNMA submitted formal comments on the Health Workforce Development Council’s Nursing Action Plan. Our comments were extensive, widely supported by ACNM documents, and are available for your review by request.
Bills, bills, bills. Spring means that bills are hot off 6. the presses and heading to committees. You have probably heard by now that CNMA is co-sponsoring legislation this year with the California Association of Nurse Practitioners. Senate Bill #1524, “The Drug and Device Furnishing Modernization Act,” is authored by Senator Ed Hernandez, chair of the Senate Health Committee. This bill would remove the redundant and restrictive requirement for 6-months of physician-supervised furnishing prior to being able to apply for a furnishing number. The current statute places a burden on new graduates, midwives that are new CA residents, as well as employers. We lobbied this bill on lobby day and continue to work hard to ensure success, but we need more CNMs to get politically involved! CNMA has been working closely regarding state policy issues with Joanna King,
Director of Government Relations at ACNM. ACNM has submitted a letter of support for SB1524.
In the first edition of the CNMA newsletter we read about UCSF’s Health Workforce Pilot Project (HWPP #171), assessing the safety of nurse practitioners, physician assistants, and CNMs in providing first trimester aspiration abortion. The initial analysis has been completed by the research team and demonstrated comparative complication rates between the advanced practice clinicians and physicians. Planned Parenthood and American Civil Liberties Union sponsored a bill authored by Senator Christine Kehoe, Senate Bill #1338. Creating policy that is consistent with the evidence, the bill would grant authority to advanced practice clinicians to perform first trimester aspiration abortion. CNMs currently have authority to perform medication abortion up until 9 weeks gestational age. The CNMA recognizes that each CNM has the autonomy in practice to decide whether or not he or she provides abortion services, and should be permitted to do so when desired. SB1338 achieves legislation that is favorable to midwifery practice and CNMA board of directors recently elected to support, along with CANP and the California Association of Physician Assistants.
For further updates, be sure to register to receive CNMA’s Google Group emails. You should also feel free to contact the Health Policy co-chairs at any time for more information, to share professional practice issues, and to ask questions regarding midwifery rules and regulations in California. 5
Student Spotlight: Carrie Jacobson, RN, CNM, MS
Carrie Jacobson is a full-time PhD student in the Department of Family Health Care Nursing at the University of California, San Francisco (UCSF). After seven years of experience caring for a diverse group of women in private and public healthcare settings, Carrie returned to school
in order to develop new knowledge to support the work of midwives and be a stronger advocate for women’s health. She has been humbled and thrilled by the opportunity to meet and learn from so many passionate and generous scholars, fellow students and teachers alike.
For her doctoral research, she plans to explore how adolescent mothers experience decision-making during
labor and birth. Carrie is particularly interested in how the experience of decision-making during labor may impact a mother’s coping and well-being (and therefore the well-being of her family) after birth. One highlight of her doctoral program has been presenting her findings from her pilot study of adolescent mothers; learning from the mothers she interviewed was a very deep honor. Ultimately, she would like to develop strategies to improve decision-making for labor and birth with the goal of supporting the health and human rights of mothers and their families.
A student’s work is never done (!) but when she’s not in the library, Carrie enjoys cuddling, playing and just general ridiculousness with her two amazing little girls out by the beach in San Francisco.
Health Policy Updatecontinued from page 3
6
So Cal Midwives Prepare to Host the ACNM Annual Meeting
CNMA is the host affiliate of the ACNM annual meeting this year and we are so happy that midwives are coming from across the country to our lovely state. The local planning committee has been working hard to prepare and we are using this opportunity to show off our California hospitality. Our group is lead by co-chairs Connie Swentek and BJ Snell. The committee includes Sheila Dell, Ruth Mielke, Monica Viera, and Candace Curlee.
The opening ceremony will feature the military midwives with a Southern California flavor that is designed to welcome and inspire. Military active duty and retired members bring your uniforms so that you can participate in the colors presentation ceremony. Contact Sheila Dell for details at [email protected].
As part of our continuing hospitality, we will be hosting a vibrant welcome booth! If you are interested in volunteering at the booth, please contact Ruth Mielke at [email protected]. We plan to manage the booth in 2-hour slots so that we all are able to attend selected educational sessions.
The CNMA Fundraising Committee is organizing gift basket donations from each CNMA chapter for raffle at the hospitality booth. Crafts, specialties and locally produced items welcome – please contact your Chapter Chair for details on how you can contribute!
At the booth SoCal chapters will also be selling various items: “midwife” t-shirts from the LA chapter, hats from the Inland Desert chapter, candles from the San Diego chapter. Local artists will have their work for display and purchase. Beautiful quilts and baskets will be raffled and blankets will be available for the Blankets for BabiesTM campaign. There will be book signing by authors presenting at the conference. For your complete relaxation, masseuses will provide chair massages. And don’t forget to pick up your pre-ordered CNMA jacket/t-shirt. With so much to offer, be sure to stop by often!
Wednesday morning from 7am-8am is the California affiliate meeting, located at the Hyatt in the Pacific room. This is your opportunity to meet the leadership in CNMA and hear about the goals of your state organization including updates from our committees: membership, CNMA annual meeting planning, fundraising, nominating, and health policy. Hear news from the State Capitol and upcoming legislative issues. This is your opportunity to make your voice heard and share with your California colleagues.
There are so many ways to enjoy Southern California, but you will not want to miss our CNMA Dinner Cruise on a Yacht! Wednesday night from 6pm-9pm. Join us for an evening out on the Long Beach harbor, touring the waters under the wide open sky and admiring the city night skyline with your friends and colleagues! Watch the sunset as you toast to the strength of midwifery and help raise funds for CNMA. This special cruise will feature a festive Mexican style dinner. Margaritas anyone? The cost is only $70 per person and space is limited, so reserve your tickets soon! Contact Monica at [email protected] or buy your ticket at the welcome booth.
The awards will be given this year at a special Oscar’s style celebration party that is not to be missed. Bring your evening attire and experience the red carpet treatment.
Also be on the look out for ads on local buses, local newspaper articles and radio spots that will highlight midwifery practice.
Last, but certainly not least, we’ve gotten some great participation from local midwifery and physician gurus as part of our educational sessions. They include people who are recognized as national experts that are sure to enhance your practice
Don’t miss this opportunity to learn about the latest in clinical practice, meet with old friends, network and just enjoy our beautiful setting in Long Beach. See you June 2-7. Register at www.midwife.org.
By Candace Curlee, CNM, ACNM Annual Meeting Planning Committee
Get a head start on your Annual Meeting Shopping!
Pre-order your CNMA jackets and t-shirts today!
http://www.customink.com/signup/nomtj80http://www.customink.com/signup/q97bzrs
California Medical Association (CMA), and California Nurse Midwives Association (CNMA).
Comments were received on the draft, which can be found on this Medical Board webpage: www.mbc.ca.gov/board/meetings/Index.html. All of the speakers expressed the belief that LMs are safe providers offering families a crucial service, and that seamless collaboration and transfer of care in the case of obstetric emergency is essential to optimizing maternal/newborn health. Current physician supervision requirements may increase perceived liability in the eyes of the physician and insurance companies. They may also limit women’s access to both low intervention midwifery care, and/or emergency medical care as appropriate. These regulations cause undue hardship to midwives, consumers, and physicians willing to provide emergency back-up services.
CMA, however, was concerned that the proposed new draft was vague and fails to clarify the extent of physician liability. An “informal collaborative relationship” does not
address the malpractice insurance companies concerns and does not allow for a formal physician/ patient relationship.
Several midwives recommended changes in the language that would further clarify the midwife/physician relationship. A draft presented by Karen Ehrlich, LM of the MAC recommends that the midwife establish a plan for accessing consultation and collaboration with a physician, and for transfer of care in case of medical necessity. This draft states that physician liability is not incurred by consultation or collaboration and begins after transfer of care is completed.
At the conclusion of the meeting, the Medical Board and the MAC agreed to integrate opinions and concerns in the reworking of the proposed regulatory changes. One hopes a more interdisciplinary, collaborative approach to maternity care is on the horizon for both LMs and CNMs and in the near future.
7
This year’s 2nd annual Midwives-PAC Rally fundraiser in Long Beach on Tuesday, June 5th at 5:45pm is shaping up to be an exciting event – we hope you are planning to attend!
At the Rally, we will hold our first “Mystery Wine Pull” fundraiser, and we need help from California midwives and students to make it a success! We are seeking 50 volunteers to bring one or two bottles of their favorite wine (each with a minimum retail value of $25). Champagne is fine, too. At the event, these bottles will be concealed in a gift box and sold for $40. 100% of proceeds will be given as campaign contributions to federal legislators of both political parties who have supported midwifery in the past or who hold leadership positions, with the ultimate goal of advancing the ACNM legislative agenda to expand our scope of practice and grow midwifery.
If you are interested, please email Erin Biscone, CNM, Midwives-PAC Board member at [email protected]. We will email you a week prior to the event to remind you to bring it. Please drop the wine off at the Midwives-PAC booth inside the Exhibit Hall, located in
the “Everything ACNM” area. The value of your in-kind donation of wine will be added to your overall annual Midwives-PAC contributions in determining your Donor’s Club level.
We also hope to see many California midwives at the rally! Tickets are $50 for midwives/guests and $15 for students. In addition to the silent and live auctions (including fabulous items such as Nora Lewis’s photography, Candace Curlee’s Palm Springs timeshare, and a week in Whistler, Canada), Debbie Jessup, CNM, Health Legislative Aide for U.S. Congresswoman Lucille Roybal-Allard (D-CA) will speak. Debbie has been instrumental in crafting the MOMs 21 Act, an innovative maternal child health bill that would reimburse midwives for supervising students in teaching facilities.
Thanks so much!
Heather Bradford, CNM, ARNP, FACNM Chair, Midwives-PAC
Have a Spare Bottle of Wine or Two?
LMs Work to Change Supervision to Collaborationcontinued from page 1
8
Hello CA midwives!
I wanted to give you some Government Affairs Committee (GAC) updates. If you want to read more about what the GAC was up to in 2011, our Annual Report is available on the CNMA website, http://california.midwife.org.
Your federal update as we move forward in 2012:
1. Hospital Privileging Bill: ACNM is working hard at getting a hospital privileging (aka “Conditions of Participation”) bill introduced. This bill would require hospitals to respond to advanced practice nurses who apply for privileges within a 60-day period. Currently, hospitals are not required to even respond to an APRN when he/she applies for privileges, let alone in a timely fashion with an explanation. It would also require all hospitals who have given privileges to APRN’s to allow them to sit on medical staff as full participants. (for example, at St. Elizabeth’s Medical Center in Boston, where I have privileges, I am considered allied health staff and cannot sit on medical staff or serve as committee chair).
We are working hard at finding a Senator on the powerful Senate Finance Committee where this bill would be referred, to introduce the bill. While there ere are no Finance committee members from California, we will be turning to you for co-sponsors once the bill is introduced and it may it may help sway our efforts if we had more information as to why this bill is important for California midwives.
What I need from you is positive and negative examples in California:
A. Are midwives able to be full participants on medical staff at hospitals in this state? Who are they and at which hospitals?
B. Do you know of specific midwives who have had difficulty attaining privileges at certain hospitals? What problems did they encounter?
PLEASE EMAIL ME DIRECTLY AT [email protected] with this information to avoid traffic on the listserve.
2. 2012 Virtual Lobby Week: Speak out for midwifery on your lunch break: It’s that easy How do you make a difference in the lives of women and families in your community? Use your voice to deliver your story to Capitol Hill during ACNM Virtual Lobby Week, May 1–3. RSVP on Facebook and stay tuned for simple instructions, call scripts, and handouts to make your interaction easy and effective. MORE at www.facebook.com/events/381468748538289/
3. PLEASE Sign up for ACNM Federal Policy Action Alerts: http://capwiz.com/acnm/mlm/signup/. Capwiz Action Alerts are sparsely but strategically timed to make the biggest impact for our collective effort and critical to advancing ACNM’s legislative agenda and keeping a midwifery “buzz” on Capitol Hill. Last year only three alerts went out, one in April for ACNM’s Virtual Lobby Day, a second in the summer coinciding with the introduction of the MOMS for the 21st Century Act, and a third during the comment period for CMS’s proposed draft regulations in December. Click here for ACNM’s formal response. The final regulations should be out soon.
4. Two exciting policy-related projects to be aware of and keep handy: the Coalition for Quality Maternity Care (CQMC)and the MLN’s Whitepaper on the Consensus Model for APRN Regulation.
The Coalition for Quality Maternity Care (CQMC) is a brand-new group of nine organizations including ACNM, who work together to advise Congress on ways to improve maternal and newborn health care in America. CQMC has taken action on legislative topics such as Quality Care for Moms and Babies Act of 2011, debt reduction, pregnant and parenting students access to education, breastfeeding, and the PREEMIE reauthorization act. The Coalition is a powerful new force on Capitol Hill to promote the best maternity care for all women and families. Goto www.midwife.org/Coalition-for-Quality-Maternity-Care for more information.
The Midwifery Licensure, Accreditation, Certification, Education (LACE) Network (MLN) whitepaper on the Consensus Model for APRN Regulation addresses provisions of the Consensus Model for APRN Regulation which require special consideration in their application for midwifery practice and can help guide their implementation. Keep this whitepaper in your virtual back pocket for any policy discussion on midwifery licensure, accreditation, certification or education; it can be found at www.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000001458/LACE_White_Paper_2011.pdf.
5. Pump up your policy savvy at the Nuts and Bolts Legislative Action Workshop on Sunday, June 3rd from 1pm-4pm at the ACNM Annual Meeting in Long Beach. Only $25 and students attend for free. Sign up for WK17 Legislative Action in 2012: Nuts and Bolts when you register or at www.multisoftevents.com/acnm12/programlisting.aspx.
As I mentioned, please keep me posted if you have legislative questions or concerns and thanks for reading!
Federal GAC Committee UpdateBy Kathryn Carr, CNM, Chair ACNM Government Affairs Committee
9
Tips for a Winning Interview
“Birth in Action”, The Film, is an inspiring and exciting journey through one family’s birth story. Both a documentary and educational birth film, “Birth in Action” intersperses footage of a woman’s labor and birth with incredibly informative dialogue and interviews. Included is meaningful discussion with one of the best American midwives, BJ Snell, and other dedicated natural birth instructors and doulas. In addition, it brings attention to the birth stories of several women and families, in which the common theme is of the empowerment of the birthing woman, and what decisions each person made to have the birth they wanted.
See more at www.
birthinaction.com
Order today atwww.amazon.
com or purchase a copy at the
ACNM Annual Meeting
Whether you’re right out of school or a seasoned midwife, job interviews can be daunting experiences. From seemingly trivial details, like what to wear, to more serious questions about whether you’ll make a good impression or be able to articulate your ideas clearly – most of us have a lot of concerns about the interview process. But with a little preparation, the midwife interview can actually be a great opportunity for personal growth and professional skill-building.
Below are some tips for a good CNM interview:
Know who you’ll be meeting with. It is perfectly acceptable to ask about who will be attending the interview. This helps you tailor your answers to the crowd and you won’t be caught off guard by a room full of people or a one-on-one talk. Knowing who you’re meeting with also helps when selecting your attire. If it’s a room full of midwives, you probably won’t need to dust off your suit or run out and buy one! However, if you’re meeting with the CEO of the hospital, you want to make sure your appearance is professional (suit still optional, but probably more appropriate here).
Come prepared. This may sound like stating the obvious, but it is best not to wing it. Make sure you know a few things about the service, such as: number of midwives and doctors in the practice, number of labor and delivery rooms or number of CNM deliveries per year. It’s also nice to know about any special distinctions, such as baby-friendly status or a low primary c-section rate. Patient demographics can also be important, especially if you have experience working with a particular group of women. Can’t find some of the practice information you’re looking for? Don’t worry. There’s usually a time in every interview when you’ll be asked if you have any questions. Use that time to show prospective employers that you’re interested in them and have been wondering about a certain aspect of their practice.
Have some clinical scenarios in mind. Think of some obstetric emergencies you’ve dealt with particularly well or an interpersonal moment in your student life where you shined. You can weave a clinical story into just about any question they throw at you. It’s a chance for you to show some of your personality, your clinical decision making skills and your strengths in general. Plus, it’s quite common for interviewers to come right out and ask for a clinical scenario, and this way you’ll be prepared.
Have a list of “must cover” items. There are always those things you absolutely want to make sure they know. Whether you want to showcase your language skills, your extensive training in a particular area, your availability or your administrative experience – don’t forget to cover your
strengths. It’s good to have at least three strengths on the bulleted list in your head. If you ever get flustered, you can go back to these.
Be honest and be you. It’s tempting to try to appeal to whoever is talking to you in an interview setting. And it is important to make a case for yourself as a midwife who will fit into the practice easily. But it’s equally important to make sure the job is right for the real you. Before the interview, think hard about your ideal job in terms of schedule, practice environment, availability of mentorship, level of autonomy, birth philosophy, etc. Knowing what kind of midwife you are (or hope to become!) is one of the keys to a successful interview. If you’re confident in what you want, you’ll have less nerves, gather more information and ultimately appeal to the right practice.
Have fun. Many of us are not accustomed to selling ourselves and do not look forward to the process. But when you’ve prepared well and meet with dynamic professionals who share your enthusiasm and passion for midwifery, your interview can start to feel like lunch with old friends.
Molly Mekjavich is a mama and CNM living in San Francisco. For a list of interview questions, please email: [email protected].
By Molly Makjavich, CNM
810
Stay connected on the web: http://california.midwife.org on Facebook: www.facebook.com/pages/California-Nurse-Midwives-Association/189568637750019
via Google Groops: [email protected]
to avoid the episiotomies that were routinely done) and active management of the third stage of labor. One of the male physicians, the only obstetrician in the group,
played the birthing woman as a midwife delivered “her” and two other midwives supported her. I can still hear his falsetto birth cries and the laughter after the “baby” was born!
It was both exciting and sobering when we divided into two smaller groups to practice the new skills in the labor and delivery unit of Katatura Hospital. Another problem: we were supposed to go to two hospitals so that the participants would have enough clinical experience, but the labor and delivery unit in one hospital was being remodeled so they could not accommodate us. This meant that not all of our participants were able to have a delivery, which was a real drawback to their gaining competence in the new skills we had taught them.
But we had successes, too. We were able to involve some family members in doing labor support, which was a first in this hospital. One striking memory was of a young nullip who arrived alone in active labor. Two doctors did labor support while a midwife was her primary provider. Suddenly she went from 5 cm to complete and within minutes delivered in the labor room. All supplies for delivery were in the delivery rooms, of course. She proceeded to have a massive hemorrhage! The midwife was a person who had been out of clinical practice for the last 20 years. He had to be eased out of the picture. One of the doctors took over and all the techniques we had been teaching came into play – fundal massage, bimanual compression, IV Pitocin, IM methergine – even inspection of the cervix for tears. It was discovered that the unit had no ring forceps to do this, but he managed anyway. The woman’s bleeding slowed, then almost stopped. The participant doctor visited her the next day and found she was feeling fine and her hematocrit was only 28 percent. We discussed the whole case in our clinical conference and the participants came up with their own algorithm for managing a postpartum hemorrhage. This was such a fine validation of their learning!
Other memories: hearing the news that the Minister of Health wanted to visit our training to “open it.” Most of a morning was spent on this ceremonial visit – speeches, distinguished visitors, and a tea. We were dying inside, knowing that precious training time was being lost, but of course there was no help for it. And the next day all 4 of us trainers were invited to the State House for a special visit with the President’s wife. More training missed! The President’s wife is a retired nurse and is very supportive of efforts to strengthen health care, so our visit was important in gaining support for maternal child health training activities.
The last two weeks of the training involved teaching our participants how to teach. The goal of our project is to train about 18 of the participants to become trainers themselves, so the LSS curriculum can be spread to 6 different training centers in Namibia. After giving them some background information, we had them teach their peers some parts of the LSS training we had just taught them. It was a shock to them just how difficult this was and how much time it took to prepare lessons, even with a well-organized framework.
This June I hope to return to Namibia with Diana for 5 weeks. We’ll teach them how to prepare a hospital to be a clinical site for LSS training like LSS – something we did not do before the training in October of 2010. It made the hospital experience much more difficult than it could have been. And we plan to coach our 18 participants as they teach their first LSS training for new participants. We hope that Namibia will have 18 Master Trainers by mid-July!
For midwives who think they are ready to become clinical trainers, there will be an all day workshop at the ACNM meeting in Long Beach in June: “Effective Teaching Skills: Becoming a Trainer for Global Health Education.” This requires completion of an approximately 8 hour on-line training program prior to the workshop.
You can find additional information on the ACNM website: “Getting Started in International Health,” www.midwife.org/index.asp?bid=409.
Teaching Life Saving Skills in Namibiacontinued from page 1
